The effectiveness of health check-ups for promoting healthy behavior: a quasi-experimental study.

The majority of western European populations do not meet current recommendations for healthy behaviour, in terms of non-smoking, sufficient physical exercise, and a healthy diet. These behaviours account for a substantial part of the total burden of disease. Promoting healthy behaviour has therefore become a central goal of public health policies. In the Netherlands, health check-ups on health behaviour are increasingly being offered as a strategy to obtain this goal. The core of these health check-ups is a risk assessment. The aim of this is to increase the awareness of participants on their health risks influenced by their personal behaviour. Awareness of people’s own risk (or susceptibility) is acknowledged as an important factor for behavioural change. Given this, health check-ups can be considered as a promising strategy to prepare people for engaging into health promotion, including organised preventive programs. Although promising, the evidence on the effectiveness of health check-ups for promoting healthy behaviour is yet limited. The wide availability and use of health check-ups in combination with the lack of evidence concerning their impact on health behaviour raises the need for the present study. The aim of this study, is to evaluate, in a quasi-experimental design, the effectiveness of a health check-up for promoting healthy behaviour, including smoking, dietary intake, physical activity, alcohol consumption and relaxation. The setting in which this will be studied is that of companies. The health check-up to be evaluated is the Prevention Compass of NIPED. In order to understand the factors that explain its effectiveness, we will also evaluate the level of participation of relevant subgroups in the health check-up, as well as the behavioural responses to the health risk assessment. Finally, we will assess whether and why the effectiveness varies according to subgroups, with a special attention to participants with an adverse risk profile, including those in lower educational groups. The study will be set up a quasi-randomised controlled trial in which a comparison will be made between participation in Prevention Compass (intervention group, n=1750) and no intervention (control group, n=1750). Both groups are formed out of employees of companies that embedded the PreventionCompass in their corporate health management strategies. The companies involved invite employees to participate in the programme in different time clusters. The first half of the clusters will serve as intervention group and the second half as control group. For both the control group as the intervention group data will be collected at baseline and after six months. For the intervention group the baseline measurement (T0) is the health check-up it self. Follow-up measurements for the intervention group will be done by sending a short electronic questionnaire with health behaviour items derived from the questionnaire of the health check-up six months after participation (T1) in the health check-up. For the control group it is the other way around. Control group members will receive a short electronic questionnaire focussing on health behaviour six months before invitation to the health check-up (T0). The actual health check-up, six months later, will then serve as follow-up measurement (T1). After six month, the change in health behaviour between T0 and T1 will be assessed and compared in both the intervention and control group. The results of this study will increase our insight into the effectiveness of health check-ups for promoting healthy behaviour, as well as into the conditions which are important for optimizing their effectiveness. This may in the long term provide an important contribution to the promotion of healthy behaviour in the Dutch population.

Participation in a health check-up results in a statistically significant positive change in health-related behaviour after 6 months.

Baseline measurement and follow-up measurement after 6 months.

The interventiongroup will participate in the PreventionCompass at baseline, and receive a short electronic lifestyle questionnaire after 6 months. The controlgroup will receive the short electronic lifestyle questionnaire at baseline, and will participate in the PreventionCompass six months later. (Cross-over design).



The PreventionCompas is an health check that consists of a questionnaire on health behaviour and socio-demographics and measurements of length, weight, waist, blood pressure and cholesterol. Based on both the responses to the questionnaire and the measurements, risk profiles are calculated for each participant. These include the risk of hypertension, hypercholesterolemia, diabetes, chronic kidney disease, and obesitas. Participants receive on a secured webpage a colour code for each risk profile: (1) green (average risk), (2) orange (moderate risk) and (3) red (high risk). Based on the magnitude of the risk, participants can be directed towards preventive interventions or a physician.



Randomisation over the intervention and controlgroup over waitingtime.